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<head>
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    <title>魔金</title>
</head>
<body>
<!--Begin Header Begin-->
<div th:replace="web/layout/mallHeader"></div>
<!--End Header End-->
<div class="i_bg bg_color">
    <!--Begin 用户中心 Begin -->
    <div class="m_content">
        <div th:replace="web/layout/mallMemberMenu"></div>
        <div class="m_right">
            <p></p>

            <div class="mem_tit">
                申请提现
            </div>
            <table border="0" cellpadding="0" cellspacing="0" class="mem_tab" style="width:930px; margin-bottom:30px;">
                <tr>
                    <td class="ma_a" colspan="2" style="padding:12px 50px;">
                        <span class="fl" style="color:#ff4e00; font-size:14px;">会员余额：<b>￥ 1000元</b></span>
                        <span class="fr"><a href="#">账户明细</a>|<a href="#">提现记录</a></span>
                    </td>
                </tr>
                <tr>
                    <td class="tx_l" width="150">提现金额</td>
                    <td width="680"><input class="tx_ipt" type="text" value="提取金额"/></td>
                </tr>
                <tr>
                    <td class="tx_l">真实姓名</td>
                    <td><input class="tx_ipt" type="text" value="姓名填写"/></td>
                </tr>
                <tr>
                    <td class="tx_l">开户行</td>
                    <td><input class="tx_ipt" type="text" value="填写银行名称"/></td>
                </tr>
                <tr>
                    <td class="tx_l">银行账号</td>
                    <td><input class="tx_ipt" type="text" value="填写银行账号"/></td>
                </tr>
                <tr>
                    <td class="tx_l">手机号</td>
                    <td><input class="tx_ipt" type="text" value="手机号码"/></td>
                </tr>
                <tr valign="top">
                    <td class="tx_l">备注</td>
                    <td><textarea class="tx_txt">会员备注</textarea></td>
                </tr>
                <tr height="70">
                    <td align="center" colspan="2">
                        <input class="btn_tj" type="submit" value="提交表单"/> &nbsp; &nbsp; <input class="btn_tj"
                                                                                                type="reset"
                                                                                                value="重置表单"/>
                    </td>
                </tr>
            </table>


        </div>
    </div>
    <!--End 用户中心 End-->
    <!--Begin Footer Begin -->
    <div th:replace="web/layout/mallFooter"></div>
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